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The optimal management of patients who do achieve a clinical complete remission after induction chemotherapy remains to be determined. Even patients who achieve a surgically confirmed complete remission have a…

The optimal frequency of follow-up examinations is unknown, but in those patients who have completed chemotherapy and who are in clinical remission it is reasonable to perform a pelvic examination and…

Many patients who have undergone optimal cytoreductive surgery and subsequent therapy for epithelial ovarian cancer will have no evidence of disease at the completion of treatment.…

At present, the treatment of choice for patients with advanced invasive epithelial ovarian cancer is cytoreductive surgery followed by six cycles of chemotherapy with a combination of carboplatin (AUC 5-6)…

As ovarian cancer spreads over the surface of the peritoneum and often recurs at this site, investigators have evaluated intraperitoneal (IP) administration of chemotherapy that can achieve high local concentrations…

Systemic chemotherapy is the standard treatment for metastatic epithelial ovarian cancer. Early studies utilized single alkylating agents such as melphalan or combinations of alkylating agents and antimetabolites. After the…

The treatment of early stage epithelial ovarian cancer must be individualized. Thorough surgical exploration and staging are indicated for all patients with early stage disease. Adjuvant treatment with chemotherapy or radiotherapy…

There is no well-established strategy for early detection of ovarian cancer. Discovery of a pelvic mass on routine physical examination can lead to surgery prior to the dissemination of a malignancy, but conventional diagnosis…

The diagnosis of ovarian cancer is usually made at laparotomy, but occasionally at laparoscopy. If a pelvic mass is suspicious and the most likely diagnosis is ovarian cancer, surgery should not be unnecessarily delayed.…

Traditionally, ovarian cancer has been considered a “silent killer” that does not produce symptoms until far advanced. Some patients with ovarian cancers confined to the ovary are asymptomatic, but the majority will have…

Ovarian epithelial tumors spread primarily by direct exfoliation of cells throughout the peritoneal cavity, but they also spread via the lymphatic and hematogenous routes. Germ cell tumors have a greater predilection…

Primary ovarian cancers are classified according to the structures of the ovary from which they are derived. Most develop from the epithelial cells that cover the ovarian surface or that line inclusion…

The prognosis of ovarian cancer can be correlated with numerous clinical and biologic factors. Tumor stage, grade, and size of metastatic disease after resection correlate best with outcome. As discussed below,…

In the human embryo, the ovary appears as a genital ridge about 1 month after fertilization. The primitive mesoderm gives rise to the mesothelial covering of the ovary and of the peritoneum, the so-called…

Most epithelial ovarian cancer is sporadic, with familial or hereditary patterns accounting for 5% 10% of all malignancies. The risk of ovarian cancer is higher than that of the general population…

A computer model simulation suggests that adding breast MRI screening may be cost-effective for women of certain ages who carry BRCA1 and BRCA2 gene mutations, according to…

Despite popular belief, a new study shows that people who smoke marijuana do not appear to be at increased risk of developing lung cancer.

It seems even heavy, long-term…

Neoplasms of trophoblastic origin can follow a spontaneous abortion, an ectopic pregnancy, or a full-term pregnancy. A hydatidiform mole is a pregnancy in which the villi have become hydropic and trophoblastic elements have proliferated.…

Primary fallopian tube cancer is rare. The average age of patients with this cancer is 50 to 60 yr. Risk factors are not well defined; however, chronic salpingitis or other inflammatory disease (such as…

Vaginal cancer accounts for 1% of gynecologic malignancies in the USA. Average age at diagnosis is 60 to 65 yr. Patients with a history of human papillomavirus infection or of cervical or vulvar cancer are…

Vulvar cancer accounts for about 3 to 4% of all gynecologic malignancies in the USA. An estimated 3,300 new cases were diagnosed in 1996. The average age at diagnosis is about 70 yr, and incidence…

Cervical cancer is the third most common gynecologic malignancy and the eighth most common malignancy among women in the USA. The mean age for developing cervical cancer is about 50 yr; however, it can affect…

Ovarian cancer is the second most commonly diagnosed gynecologic malignancy, the deadliest gynecologic malignancy, and the fourth leading cause of cancer-related deaths in women in the USA. About 1 in 70 women eventually develops ovarian…